TY - JOUR
T1 - Parsing the impact of early detection on duration of untreated psychosis (DUP)
T2 - Applying quantile regression to data from the Scandinavian TIPS study
AU - Ferrara, Maria
AU - Guloksuz, Sinan
AU - Li, Fangyong
AU - Burke, Shadie
AU - Tek, Cenk
AU - Friis, Svein
AU - Hegelstad, Wenche ten Velden
AU - Joa, Inge
AU - Johannessen, Jan Olav
AU - Melle, Ingrid
AU - Simonsen, Erik
AU - Srihari, Vinod H.
N1 - Funding Information:
This work was supported by grant R01MH103831 to VS from the National Institutes of Health . The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
This work was supported by grant R01MH103831 to VS from the National Institutes of Health. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.The TIPS project was supported by the Norwegian National Research Council (133897/320), the Norwegian Department of Health and Social Affairs, the National Council for Mental Health/Health and Rehabilitation (1997/41 and 2002/306), Rogaland County and Oslo County (Per Vaglum, J.O.J. S.F. Tor K. Larsen, I.M. Stein Opjordsmoen). It was also funded by the Theodore and Vada Stanley Foundation, the Regional Health Research Foundation for Eastern Region, Denmark; Roskilde County, Denmark, Helsefonden Lundbeck Pharma, Eli Lilly and Janssen^Cilag Pharmaceuticals (E.S.Ulrik Haahr), and by a National Alliance for Research on Schizophrenia and Depression (NARSAD). Distinguished Investigator Award and NIMH grant MH-01654 (Thomas H. McGlashan) and a NARSAD Young Investigator Award (Tor K. Larsen).
Funding Information:
The TIPS project was supported by the Norwegian National Research Council ( 133897/320 ), the Norwegian Department of Health and Social Affairs , the National Council for Mental Health/Health and Rehabilitation ( 1997/41 and 2002/306 ), Rogaland County and Oslo County (Per Vaglum, J.O.J., S.F. Tor K. Larsen, I.M., Stein Opjordsmoen). It was also funded by the Theodore and Vada Stanley Foundation , the Regional Health Research Foundation for Eastern Region, Denmark ; Roskilde County, Denmark , Helsefonden Lundbeck Pharma , Eli Lilly and Janssen^Cilag Pharmaceuticals (E.S.Ulrik Haahr), and by a National Alliance for Research on Schizophrenia and Depression (NARSAD). Distinguished Investigator Award and NIMH grant MH-01654 (Thomas H. McGlashan) and a NARSAD Young Investigator Award (Tor K. Larsen).
Publisher Copyright:
© 2019
PY - 2019/8
Y1 - 2019/8
N2 - Background: Prolonged duration of untreated psychosis (DUP) is associated with poor outcomes. The TIPS study halved DUP with an early detection (ED) campaign; however, conventional statistical analyses, focused on mean estimates, failed to reveal the effects of ED across the full DUP distribution, restricting inferences about ED's effectiveness. Utilizing a novel quantile regression based analysis, we examined the differential impact of ED across DUP. Secondary analysis explored possible predictors of DUP, and moderators of the effect of the campaign.Methods: The TIPS ED campaign was conducted in two health care sectors in Norway, with two equivalent health care sectors serving as controls. Quantile regression analysis was performed to analyze ED campaign's effect.Results: 281 patients with first episode psychosis were recruited, including 141 from the ED area. ED had no effect on the first quartile (Q1) of DUP, whereas a significant reduction in Q2 (11 weeks), and Q3 (41 weeks) of DUP was observed. The effect of ED was significantly stronger on reducing Q3 than Q1 or Q2, suggesting that the campaign was more effective in longerDUP samples. Male gender and single status predicted longerDUP inQ3: by 38 and 27 weeks, respectively. Single status, but not gender, emerged as a significant moderator of ED campaign effect.Conclusions: Quantile regression provided in depth information about the non-uniformity, and moderators, of TIPS's ED effort across the full distribution of DUP, demonstrating the value of this analytic approach to re-examine prior, and plan analyses for future, early detection efforts. (C) 2019 Published by Elsevier B.V.
AB - Background: Prolonged duration of untreated psychosis (DUP) is associated with poor outcomes. The TIPS study halved DUP with an early detection (ED) campaign; however, conventional statistical analyses, focused on mean estimates, failed to reveal the effects of ED across the full DUP distribution, restricting inferences about ED's effectiveness. Utilizing a novel quantile regression based analysis, we examined the differential impact of ED across DUP. Secondary analysis explored possible predictors of DUP, and moderators of the effect of the campaign.Methods: The TIPS ED campaign was conducted in two health care sectors in Norway, with two equivalent health care sectors serving as controls. Quantile regression analysis was performed to analyze ED campaign's effect.Results: 281 patients with first episode psychosis were recruited, including 141 from the ED area. ED had no effect on the first quartile (Q1) of DUP, whereas a significant reduction in Q2 (11 weeks), and Q3 (41 weeks) of DUP was observed. The effect of ED was significantly stronger on reducing Q3 than Q1 or Q2, suggesting that the campaign was more effective in longerDUP samples. Male gender and single status predicted longerDUP inQ3: by 38 and 27 weeks, respectively. Single status, but not gender, emerged as a significant moderator of ED campaign effect.Conclusions: Quantile regression provided in depth information about the non-uniformity, and moderators, of TIPS's ED effort across the full distribution of DUP, demonstrating the value of this analytic approach to re-examine prior, and plan analyses for future, early detection efforts. (C) 2019 Published by Elsevier B.V.
KW - Psychosis
KW - Early detection
KW - Schizophrenia
KW - Early intervention
KW - Untreated psychosis
KW - 1ST-EPISODE PSYCHOSIS
KW - 1ST EPISODE
KW - EARLY IDENTIFICATION
KW - SCHIZOPHRENIA
KW - SYMPTOM
KW - REMISSION
KW - PATTERNS
U2 - 10.1016/j.schres.2019.05.035
DO - 10.1016/j.schres.2019.05.035
M3 - Article
C2 - 31204063
SN - 0920-9964
VL - 210
SP - 128
EP - 134
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -